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A comprehensive set of pediatric nursing practice questions and answers designed to help nursing students prepare for their exams. It covers a wide range of topics relevant to pediatric patient care, including common childhood illnesses, nutritional guidance, medication administration, and developmental milestones. Each question is accompanied by a detailed rationale to enhance understanding and critical thinking skills. This resource is invaluable for students seeking to master pediatric nursing concepts and excel in their studies, offering practical insights and evidence-based information to support effective patient care and decision-making in pediatric settings. The questions are designed to simulate real-world scenarios, promoting the application of knowledge and the development of clinical judgment.
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A. Concave fingernails B. Joint pain and stiffness C. Prominent frontal bossing D. Increased risk of infection
Answer: B Rationale: Hemophilia A is a bleeding disorder characterized by a deficiency of factor VIII. Children commonly experience bleeding into joints (hemarthrosis), leading to joint pain and stiffness. Concave fingernails (A) suggest iron-deficiency anemia, prominent frontal bossing (C) is more often associated with conditions like thalassemia, and increased infection risk (D) is not the hallmark of hemophilia.
Rationale: Tdap is routinely given around 11–12 years of age as a booster. Hib (A), RV (B), and final IPV (C) doses are typically completed by early childhood.
A. “I will give my child a double dose if a dose is missed.” B. “I will give this medication with skim milk.” C. “This medication will turn my child’s stools white.” D. “I will give this medication to my child using a straw.”
Answer: D Rationale: Iron can stain tooth enamel. Administering it with a straw (or dropper) minimizes contact with teeth. Giving double doses (A) can lead to toxicity. Milk (B) decreases iron absorption. Iron often turns stools dark or black, not white (C).
A nurse at a provider’s office is preparing to administer scheduled vaccines to an infant when the parent refuses. Which action should the nurse take FIRST?
A. Ask the parent why they do not want the vaccines. B. Provide the parent with a Vaccine Information Statement (VIS). C. Ask if the parent’s other children received immunizations. D. Inform the parent that the vaccines must be given at the next visit.
Answer: B Rationale: By law, parents must receive the VIS before each vaccine. This provides accurate, evidence-based information for informed decision- making. Exploring reasons (A) is important, but the first step is to provide the VIS.
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A. Position the child with their head flexed downward. B. Apply pressure to the lacrimal punctum for 1 min following administration. C. Hold the dropper 5 cm (2 in) above the eye when instilling medication. D. Wipe excess medication from the inner canthus toward the outer canthus.
Answer: B
Scenario: A school-age child is on postoperative Day 1 following an appendectomy. Vital signs show: T 38.6°C (101.5°F), HR 110/min, RR 24/min, BP 100/60 mm Hg, O₂ sat 95% on room air. Which of the following findings is MOST indicative of a potential postoperative complication?
A. Mild fatigue B. Fever to 38.6°C (101.5°F) C. Heart rate of 110/min D. Decreased appetite
Answer: B Rationale: A postoperative fever can be an early sign of infection or another complication. Mild fatigue (A) and decreased appetite (D) can be normal in the early postoperative period. A heart rate of 110/min (C) may be slightly elevated due to postoperative pain or mild dehydration but is not as concerning as an unexplained temperature elevation.
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A. “My child has refused to drink fluids for the past 8 hours.” B. “My child has been coughing at night.”
C. “My child’s voice sounds very hoarse, and they have a fever of 100.4°F.” D. “My child recently had the flu.”
Answer: A Rationale: Refusal of fluids for 8 hours can lead to dehydration, which is especially concerning with respiratory illnesses like croup. Nighttime coughing (B), moderate hoarseness and mild fever (C), and a recent viral illness (D) are common in croup but do not demand the same immediate intervention as possible dehydration.
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A. Blood glucose levels remain within normal range. B. Reduced frequency and fat content of stools. C. Normal sweat chloride level. D. Normal BUN and creatinine clearance.
Answer: B Rationale: Pancrelipase improves digestion of nutrients, decreasing the fat content in stools and reducing the number of stools. CF commonly affects the pancreas, but this medication does not directly normalize sweat chloride
A. Increased urine specific gravity B. Increased calcitonin level C. Increased cortisol level D. Decreased hemoglobin level
Answer: D Rationale: In sickle cell anemia, hemolysis and sickling of RBCs can lead to a decreased hemoglobin level. Options A, B, and C are not typical changes associated with sickle cell disease.
A. Ask the toddler to state their name. B. Confirm the child’s room number with the pharmacy. C. Compare the child’s appearance to the ID photo on the chart. D. Ask the guardian to verify the child’s name.
Answer: D Rationale: For a toddler who may not reliably identify themselves, verifying the child’s name and date of birth with the guardian (and cross-checking the
ID band) is safest. Relying on room numbers (B) or a toddler’s own statement (A) can lead to errors.
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A. Preferring vegetables more than fruits B. Consuming ~2,000 calories daily C. Fasting twice a week to manage intake D. Increasing intake during track season
Answer: C Rationale: Routine fasting can compromise nutritional status and is especially risky during adolescence, a period of rapid growth. Preferring vegetables over fruits (A) and increasing intake during sports (D) can be normal patterns if balanced overall.
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D. “Your provider will prescribe additional vitamin A supplements.”
Answer: B Rationale: Isotretinoin is known to be teratogenic, so two negative pregnancy tests and reliable contraceptive methods are required. It is an oral medication, not topical (A). Monitoring focuses on liver function and lipid levels, not kidney function alone (C). Additional vitamin A supplements (D) can increase toxicity and are contraindicated.
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A. Protective environment B. Contact precautions C. Airborne precautions D. Droplet precautions
Answer: D Rationale: Hib meningitis is transmitted through respiratory droplets, hence droplet precautions are essential. Protective environment is for immunocompromised clients, contact is for direct/indirect contact with infectious material, and airborne is for illnesses like tuberculosis or measles.
A. Wheezing B. Angioedema C. Hives (urticaria) D. Hypotension
Answer: C Rationale: Hives (urticaria) often appear early in anaphylaxis. Respiratory distress (wheezing) and circulatory compromise (hypotension) usually develop later if immediate intervention is not provided.
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A. Drowsiness B. Throat pain
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A nurse is reinforcing teaching with the parent of a school-age child who has lactose intolerance. Which of the following supplements should the nurse instruct the parent to include in the child’s diet?
A. Zinc B. Vitamin D C. Thiamine D. Folic acid
Answer: B
Rationale:
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A nurse is reinforcing teaching with the guardian of a toddler who is receiving chemotherapy and has developed stomatitis. Which of the following instructions should the nurse include?
A. Administer viscous lidocaine before feedings. B. Brush the toddler’s teeth with a firm-bristled toothbrush. C. Frequently rinse the mouth with chlorhexidine mouthwash. D. Increase vitamin C intake by offering orange slices.
Answer: C
Rationale:
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Scenario: A 3-year-old presents to the emergency department with abrupt onset of fever, sore throat, and painful swallowing. The parent reports the child’s voice sounds muffled. The child is irritable, sitting in a tripod position with chin thrust forward and tongue protruding, excessive drooling,
A nurse in an emergency department is evaluating a toddler with an acute onset of a sore throat, high fever, drooling, and a muffled voice. Which of the following presentations is MOST consistent with acute epiglottitis?
A. Gradual onset of symptoms with a barky cough, low-grade fever. B. Sudden onset with high fever, drooling, muffled or “hot potato” voice. C. Abrupt onset of a barky cough, typically worse at night. D. Gradual onset of mild fever, mild cough, and hoarseness.
Answer: B
Rationale:
━ Scenario: A 3-year-old with a probable diagnosis of acute epiglottitis arrives at the emergency department. The nurse reviews provider prescriptions. Which of the following actions should the nurse take FIRST?
A. Attempt to visualize the child’s posterior pharynx with a tongue depressor. B. Administer humidified oxygen.
C. Ensure that resuscitation equipment is readily available at the bedside. D. Prepare to administer IV antibiotics immediately.
Answer: C
Rationale:
Follow-Up Action: After ensuring emergency equipment is available, the nurse should administer humidified oxygen to support oxygenation until definitive treatment (e.g., intubation, antibiotics) is provided.
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A nurse is collaborating with the interprofessional team to plan care for a toddler diagnosed with acute epiglottitis. Which TWO of the following interventions should the nurse recommend including in the care plan?
